ENDOMETRIAL LESIONS' HISTOPATHOLOGICAL PATTERNS IN WOMEN WITH ABNORMAL UTERINE BLEEDING

Abstract

BACKGROUND: Unusual bleeding from the uterus (AUB) is one of the most frequent and difficult issues that gynecologists encounter. The best diagnostic method for assessing AUB is the histopathological analysis of an endometrial sample. The most frequent presenting symptom in the gynecology outpatient department is abnormal uterine bleeding (AUB). While endometrial sampling may be useful as the initial diagnostic step in AUB, pathologists in practice may occasionally find it difficult to interpret the results. In order to determine the endometrial etiology of AUB, this study examined the endometrium's histology. Additionally, we made an effort to track the prevalence of different pathologies in age groups that presented with abnormal uterine bleeding.
AIM: The aim of the study was to determine the spectrum of endometrial pathologies in different age groups of patients presenting with AUB.
 MATERIAL AND METHOD: The Department of Pathology carried out this retrospective investigation. By using inclusion and exclusion criteria, 100 cases in total were analyzed. The following patients were excluded: those having a gestational cause, hemostatic conditions, isolated cervical or vaginal disease, and leiomyoma. The case records from the Medical Records Department were used to gather pertinent clinical information regarding age, pattern, and duration of abnormal bleeding, menstrual history, obstetric history, use of exogenous hormones, physical and gynecological examination findings, lab investigation results, and sonological and hysteroscopic findings. A very well-structured proforma was used to record all the data. Hysterectomy or endometrial curetting were used to extract endometrial specimens, which were then fixed in 10% formalin.
RESULTS: The age of patients ranged from 23-60 years. The mean age of women presented with AUB in our study was 40.2 years. The maximum number of patients 70 were in the age group 41-50 years, followed by 60 patients in the age group of 31-40 years. Out of 150 patients, 90 were due to functional causes as no organic pathology was found, while 60 cases showed definite endometrial pathology. Out of 90 functional causes of AUB, proliferative endometrium 49 was the most common pattern. Out of 60 organic causes, endometrial hyperplasia 40 was the most common. Out of the 40 cases of endometrial hyperplasia, 22 cases of simple hyperplasia without atypia, 2 cases of simple hyperplasia with atypia, 8 cases of complex hyperplasia without atypia, and a single case of complex hyperplasia with atypia.
CONCLUSION: AUB is brought on by age-related disease in the endometrium. AUB is evaluated using endometrial biopsy histopathology as a key diagnostic technique, and a definite diagnosis could aid the doctor in formulating a treatment strategy for the effective management of AUB. Endometrial biopsy and curettage histopathological patterns in women with AUB are varied. These lesions range from straightforward physiological to incredibly complex pathological ones. The vast majority of the lesions causing AUB found in this investigation were fetal lesions, which are most frequently found in female reproductive patients.
KEYWORDS: Abnormal Uterine Bleeding (AUB); Dysfunctional Uterine Bleeding (DUB), Endometrial Lesions and Histopathological Pattern